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Novel TBX1 loss-of-function mutation causes isolated conotruncal heart defects in Chinese patients without 22q11.2 deletion.
[22q11.2 deletion syndrome]
TBX
1
and
CRKL
haploinsufficiency
is
thought
to
cause
the
cardiac
phenotype
of
the
22
q
11
.
2
deletion
syndrome
.
However
,
few
unequivocal
mutations
of
TBX
1
and
CRKL
have
been
discovered
in
isolated
conotrucal
heart
defects
(
CTDs
)
patients
.
The
aim
of
the
study
was
to
screen
the
mutation
of
TBX
1
and
CRKL
in
isolated
CTDs
Chinese
patients
without
22
q
11
.
2
deletion
and
identify
the
pathomechanism
of
the
missense
mutations
.
We
enrolled
199
non-
22
q
11
.
2
deletion
patients
with
CTDs
and
139
unrelated
healthy
controls
.
Gene
sequencing
were
performed
for
all
of
them
.
The
functional
data
of
mutations
were
obtained
by
in
vitro
transfection
and
luciferase
experiments
and
computer
modelling
.
Screening
of
the
TBX
1
coding
sequence
identified
a
de
novo
missense
mutation
(
c
.
385
G
 
→
 
A
;
p
.
E
129
K
)
and
a
known
polymorphism
(
c
.
928
G
 
→
 
A
;
p
.
G
310
S
)
.
In
vitro
experiments
demonstrate
that
the
TBX
1
E
129
K
variant
almost
lost
transactivation
activity
.
The
TBX
1
G
310
S
variant
seems
to
affect
the
interaction
of
TBX
1
with
other
factors
.
Computer
molecular
dynamics
simulations
showed
the
de
novo
missense
mutation
is
likely
to
affect
TBX
1
-
DNA
interaction
.
No
mutation
of
CRKL
gene
was
found
.
These
observations
suggest
that
the
TBX
1
loss
-of-function
mutation
may
be
involved
in
the
pathogenesis
of
isolated
CTDs
.
This
is
the
first
human
missense
mutation
showing
that
TBX
1
is
a
candidate
causing
isolated
CTDs
in
Chinese
patients
without
22
q
11
.
2
deletion
.
Diseases
Validation
Diseases presenting
"few unequivocal mutations"
symptom
22q11.2 deletion syndrome
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